Kasparian N A, Meiser B, Butow P N, Simpson J M, Mann G J
Psychosocial Research Group, Department of Medical Oncology, Prince of Wales Hospital, Randwick, Australia.
Clin Genet. 2008 Feb;73(2):121-31. doi: 10.1111/j.1399-0004.2007.00949.x. Epub 2007 Dec 28.
Despite rapid advancements in molecular genetics research, little is known about the psychological experiences of individuals with a family history of melanoma. The present study aimed to identify factors contributing to psychological distress among affected and unaffected individuals with a strong family history of melanoma. A total of 121 adults who had recently been informed of the identification of a family-specific mutation in the CDKN2A melanoma susceptibility gene, completed a self-report questionnaire assessing cancer-specific and generalized distress, and a variety of potential predictors. Having a personal history of melanoma (OR = 3.37, p = 0.033), perceiving greater family implications of melanoma (OR = 2.52, p < 0.0001), and the tendency to monitor for threatening information (OR = 3.12, p = 0.008) were associated with melanoma-specific distress. Being childless (beta = 2.09, p = 0.007), perceiving sun exposure as an important cause of melanoma (beta = 1.15, p = 0.015), and perceiving greater family implications of melanoma (beta = 1.02, p = 0.002) were associated with greater generalized anxiety, while monitoring moderated the relationship between endorsement of a genetic model of melanoma and generalized anxiety (p = 0.005). As in other common familial cancers, distress was relatively uncommon in this familial melanoma cohort, even after notification of the presence of a family mutation. Participants do not contemplate their melanoma risk in isolation, but evaluate their risk vis-à-vis the experiences of their relatives.
尽管分子遗传学研究取得了迅速进展，但对于有黑色素瘤家族史的个体的心理体验却知之甚少。本研究旨在确定在有黑色素瘤家族史的患病和未患病个体中，导致心理困扰的因素。共有121名成年人最近被告知在CDKN2A黑色素瘤易感基因中发现了家族特异性突变，他们完成了一份自我报告问卷，评估癌症特异性和广泛性困扰以及各种潜在预测因素。有黑色素瘤个人病史（比值比=3.37，p=0.033）、认为黑色素瘤对家庭影响更大（比值比=2.52，p<0.0001）以及监测威胁性信息的倾向（比值比=3.12，p=0.008）与黑色素瘤特异性困扰相关。无子女（β=2.09，p=0.007）、认为阳光暴露是黑色素瘤的重要病因（β=1.15，p=0.015）以及认为黑色素瘤对家庭影响更大（β=1.02，p=0.002）与更高的广泛性焦虑相关，而监测调节了黑色素瘤遗传模型的认同与广泛性焦虑之间的关系（p=0.005）。与其他常见的家族性癌症一样，即使在被告知存在家族突变后。在这个家族性黑色素瘤队列中，困扰相对不常见。参与者并非孤立地考虑自己的黑色素瘤风险，而是根据其亲属的经历来评估自己的风险。
